Employee Benefits Guide 2019/2020

Open Enrollment begins: May 1st and will end May 31st On-Site enrollment is May 7th-9th

Checklist: REVIEW benefits offered

Medical/Prescription Dental Vision Life Insurance Retirement Options Voluntary Benefits Flexible Spending Account/Dependent Care

Account DETERMINE CHANGES

Determine any changes that you are wanting/needing to make to your benefits for the 2019/20 plan year.

GATHER THE APPROPRIATE DOCUMENTATION Marriage Certificate Birth Certificate Legal Documents for verification

On Site Enrollment is May 7th-9th

Before You Enroll… WHOM CAN I ENROLL? If you are eligible for coverage, you can also enroll your eligible spouse and eligible dependents for medical, dental, vision, spouse and/or child life insurance, and the voluntary insurance plans. If requested, you must provide documentation proving that your Spouse and/or Child(ren) meet eligibility requirements. ELIGIBLE DEPENDENTS INCLUDE: • Your legal spouse (for medical coverage: your spouse is only eligible if he/she can present valid

documentation). • Your children (or stepchildren) by birth, marriage, legal adoption or legal guardianship (proper

documentation required). o Up to age 26 for medical, dental and vision

• Up to age 19 (23, if full‐time student) for life and supplemental life • Your children, of any age, who become totally and permanently disabled before age 19 while covered

by the plan(s). • Dependents covered under a Qualified Medical Child Support Order (proper documentation

required). • Once your benefit elections become effective, they remain in effect until the end of the fiscal year.

*You may only change coverage within 30 calendar days of a qualified event. MY SPOUSE AND I BOTH WORK FOR ANDERSON COUNTY, WHAT OPTIONS DO WE HAVE FOR COVERAGE? If you are NOT covering eligible dependent children: • You may each enroll in Employee Only coverage • One employee may enroll in Employee + Spouse coverage and the other decline coverage. If you ARE covering eligible dependent children: • One employee may enroll in Family coverage and the other decline coverage. • One employee may enroll in Employee + Child(ren) and the other enroll in Employee Only coverage.

• You are NOT allowed to duplicate medical, dental, or vision coverage on any family member. If you are currently violating eligibility rules, you must correct this to prevent further action, including loss of insurance. Each employee may enroll in Employee + Child(ren) coverage if you are covering more than one eligible child, but you may not duplicate coverage on any individual. Contact Human Resources Risk Management Department for assistance: 865-264-6300. QUALIFYING EVENTS: You must notify the Human Resource & Risk Management Department within 30 calendar days qualified life event. You will be asked to provide documentation of the event. If you do not contact the Human Resource Department within 30 days of the qualified event, you will have to wait until the next annual enrollment period to make changes (unless you experience another qualified life event). Qualifying Events are: • Marriage • Divorce or legal separation • Birth of your child • Death of your spouse or dependent child • Adoption of or placement for adoption of your child • Change in employment status of employee, spouse or dependent child

What Is New For 2019? MEDICAL COVERAGE – MEDBEN (PHCS NETWORK) MedBen has been chosen as Anderson County Governments TPA for our Health and Prescription Coverage for 2019/20. A TPA, (third party administrator) is used because Anderson County is Self‐Funded (meaning, the County pays all medical and prescription claims from the collected premiums), we use a TPA to manage our health and prescription benefits. The MedBen medical in‐network provider is PHCS Multi Wrap Network. MedBen will process our claims and look for any billing errors within those claims. The use of a TPA (MedBen) helps Anderson County remain transparent in our healthcare costs while ensures that we have access to programs and data to keep the employee costs at a manageable rate. Anderson County Government’s self‐funded programs administered through MedGen via PHCS Multi‐wrap Network remains the two (2) tiered plan options (Gold/Silver). PHCS Network: https://www.multiplan.com/

To Find a Provider: 1. Click Find a Provider 2. Select a Network –‘PHCS’ 3. Next Question answer ‘I don’t see any of these statements” 4. Type in Provider or Facility Name and Zip Code (close to area will work) 5. Click the Search symbol

A list of in‐network providers will populate.

PRESCRIPTION COVERAGE - VENTEGRA

We have prescription coverage, which is Self‐Funded through Anderson County Government, and is administered through MedBen via Ventegra, Inc. Ventegra is a pharmacy services administrator that goes beyond traditional Rx management to provide greater cost savings. They price medications based on the wholesale price, so what is paid to the pharmacy is the same as what is billed to the plan. That goes for brand name prescriptions as well as popular over‐the‐counter products.

https://www.ventegra.com

DENTAL – DELTA DENTAL

Our dental coverage is fully funded, and provided through Delta Dental. We have added 2 options to our dental coverage, totaling 3 tiers. Each tier has a different Yearly Maximum Benefit for each covered member, and are available for purchase through payroll deduct at a very reasonable rate.

www.deltadental.com

What Is New For 2019? (cont.) VISION – VSIONBLUE/EYEMED

Our vision coverage is fully funded and administered thru Blue Cross Blue Shield, via VisionBlue and EyeMed. Effective July 1, 2019, there will be an increase in the allowable retail increase from $120 to $150.

LIFE – NABCO/ABACUS

Anderson County has increased the Life and AD&D Coverage the County provides at no cost to its full time employees. The increase of employee life benefit is from $25,000 coverage to $50,000 beginning July 1, 2019.

VOLUNTARY BENEFITS - AMERICAN FIDELITY

American Fidelity offers many voluntary products for you to choose from that will suit the needs of you, your family and your financial situation. This year they have added a new Hospital Assist Program.

FLEXIBLE SPENDING (FSA) - TASC

TASCwill be administering our Flexible Spending beginning July 1, 2019. Flex Spending does not automatically re‐enroll, you must elect this benefit at Open Enrollment or when you complete Orientation to participate in the Flex program.

RETIREMENT OPTIONS – TENNESSEE CONSOLIDATED RETIREMENT SYSTEMS (TCRS)

This year Anderson County Government has enrolled in optional retirement plans through TCRS, effective July 1, 2019. You now have the choice of adding a 401k (before/after tax) or a 457b via payroll deduct, along with your Legacy Plan that it currently in place.

https://treasury.tn.gov/Retirement/Retire-Ready-Tennessee/Discover-RetireReadyTN

• The Legacy Plan – Mandatory enrollment with a 5% deduction per pay period, start dates may vary depending on prior TCRS membership. Fully vested after 5 years continuous Full Time employment.

• 401(k) Before Tax Plan, 401(k) After Tax Roth, 457(b) Before Tax Plan – optional

Are you financially prepared for a medical emergency?

• If you experienced a medical emergency, would you be prepared to cover the out-of-pocket medical expenses?

• And, what about everything else that adds up, like bills, groceries, and housing?

• Major medical insurance plans are designed to pay a large portion of your

medical costs. But with a deductible to be met, you must pay out of your own pocket until you meet your deductible and plan maximum.

That’s where AF Hospital Assist™ can help

SECTION 1

Medical – Prescription - Vision - Dental - Premiums

Your Medical & Prescription Coverage Anderson County offers you a choice of medical plan options, a Gold Plan or a Silver Plan so you can choose the plan that best meets your needs – and those of your family. Each plan includes comprehensive health care benefits including free preventive care services, usage of Thrive Health and Wellness Center and coverage for prescription drugs and vision services.

HEALTH COVERAGE OPTIONS Both Gold and Silver plans cover office visits and preventative care services at 100% after you pay a copay (determined by plan choice), plus other additional services paid at 100%.

The Gold Plan: offers slightly higher payroll deductions and has County contributions of $439/Single, $1,114/Emp.+1 or $1,310/ Family, that offset your premium cost, while carrying a lower deductible for ER visits and other services. The Gold plan has an 80/20 coinsurance after the deductible has been met.

The Silver Plan: offers lower payroll deductions, but with a higher deductible and has County contributions of $439/Single, $1,156/Emp.+1 or $1,226/Family, that offset your premium cost, while carrying a higher deductible for ER visits and other services. The Silver plan has a 70/30 coinsurance after the deductible has been met. (See Section 1, Employee Rates for monthly premiums)

PRESCRIPTION DRUG COVERAGE All of the medical plan options include coverage for prescription drugs, through a third party administrator,

MedBen. MedBen uses Ventegra, Inc pharmaceutical claims processing. You have two ways to purchase prescription drugs, (1) at any pharmacy, with the exception of Walgreens

(2) through mail order. PHARMACY PROGRAM

For your short‐term medication needs, you can fill your prescription at any pharmacy, with the exception of Walgreens. The usage of any Walgreens has been excluded from the pharmacy program. If you choose to use any Walgreens, you are solely financially responsible for the complete prescription cost. For maintenance medications that are taken regularly, you can choose to fill your prescription in a 90‐day supply through MedVantx or Costco’s mail order program, as noted below. Remember! There is a calendar year pharmacy deductible that must be met prior to paying discounted prices for medications. The deductible depends on the health plan you have chosen. MAIL ORDER PROGRAM The mail order program saves you money when you take medication for any ongoing or chronic condition. You can purchase up to a 90‐day supply and have your prescriptions shipped directly to your home. MedVantx or Costco are allowable for Mail Order Prescriptions.

Affordable Patient-Centered Care is available to… Active Employees, retirees, their spouses and dependents (age 2 and older) who are enrolled in an Anderson County Government health plan are eligible to receive FREE health care through Thrive Health and Wellness Center located in Anderson County Courthouse, Clinton TN.

*You must have an appointment to be seen at Thrive Health & Wellness Center.

PERSONABLE CARE

All clinics are managed by CareHere, an independent company, and staffed by highly qualified, board certified physicians and licensed nurse practitioners with expertise in the areas of primary care, family practice and women’s health. Most services you receive from your primary care doctor are available at the clinics, including:

• Acute and chronic condition care • Lab services • Immunizations and vaccinations • Allergy management • Sports physicals • Minor complaints about pain/sprains/strains • Annual preventive exams (men and women) • Injections (allergy, hormones, etc.)

even when they are prescribed by your primary care doctor

Thrive Health and Wellness Center stocks many generic medications to be dispensed at no cost to you when it is prescribed by a CareHere board‐certified physician or licensed nurse practitioner.

CLINIC LOCATION Thrive Health & Wellness Center (In Anderson County Courthouse)

100 N. Main Street Suite 105 Clinton, TN 37716 Phone: 877‐423‐1330 Mon 7:30a‐4:30p * Tues Closed Wed 7:30a‐4:30p* Thurs 7:30a‐4:30p * Fri 7:30a‐12p

*Closed for lunch from 12:30‐1:00p daily

6

To download, go to CareHere.com/App or Search CareHere and download it in the Apple & Google Play stores.

WE ARE HERE FOR YOU

CareHere's qualified staff can meet many of your medical needs. To schedule an appointment, call 877‐423‐1330; visit our patient portal at www.carehere.com or via the mobile app: CareHere Patient Portal.

Thrive Health & Wellness Center - CareHere DO I HAVE TO CREATE A NEW LOGIN FOR CAREHERE? Yes. You are required to create a user name and password for every person over the age of 2, that will be utilizing Thrive Health & Wellness. All records are HIPAA guarded.

HOW DO I COMPLETE REGISTRATION FOR THRIVE HEALTH & WELLNESS THROUGH CAREHERE? Each eligible participant must be registered separately. There are two ways patients can complete registration with CareHere. Patients can call 877.423.1330 or follow the steps below at https://carehere.com/home to register.

1. Click Member Login 2. Click I need to register for the first time with my Access Code 3. Enter your Access Code: ANCTA2 4. Click Go 5. Provide responses to the ALL questions on the next 4 web pages of the health questionnaire, including Contact Data and Health and Behavioral Data.

FA Q's

Is it a Walk in Clinic?

- No, Thrive Health & Wellness Center sees its patients by appointment only.

HOW DO I MAKE AN APPOINTMENT?

There are 3 ways to make an appointment for the Thrive Health and Wellness Center:

1. Call 1‐877‐423‐1330 2. CareHere Patient Portal ‐ www. carehere.com 3. CareHere Mobile App

Thrive Health & Wellness Center (cont.)

WILL ANDERSON COUNTY/MY EMPLOYER, HAVE ACCESS TO MY MEDICAL RECORDS? No. Usage of the Thrive Health & Wellness Center for personal health is voluntary and private. Your personal health information will not be shared with your employer. CareHere abides by all federal HIPAA and confidentiality regulations.

MAY I HAVE A COPY OF MY ELECTRONIC MEDICAL RECORD FAXED TO ANOTHER DOCTOR? Yes. The staff will be more than happy to fax your electronic medical record to another doctor on your behalf. To process your request, they will need the following information:

* Your name, date of birth, and the last four digits of your SSN. * The name and fax number of the doctor or practice to which you would like your electronic medical record to be sent.

HOW DOES THE THRIVE HEALTH & WELLNESS CENTER BENEFIT ME? ANDERSON COUNTY? Given the ever‐increasing costs of healthcare, the Thrive Health & Wellness Center saves both you and Anderson County money. Healthcare in the United States tends to be reactive instead of proactive. People get sick, and they go to the doctor. The Thrive Health & Wellness Center provides high‐quality care when patients are sick, but also strive to provide patients with proactive, preventive services. CareHere providers and staff will work with you to understand your history, your lifestyle, and to provide health and wellness services designed to lower your risks and improve your health. Anderson County's ultimate goal is to provide the highest quality services for the citizens it serves. In order to do this, it needs to continue to attract and retain employees and to provide competitive benefit programs. It is important to Anderson County that our employees are able to live to their fullest and healthiest potential. It believes providing the Thrive Health & Wellness Center will offer an opportunity to control rising healthcare costs for employees, provide additional resources to help them live happy and healthy lives, and sustain its ability to serve its citizens.

Your Dental Plan DELTA DENTAL It is important to have regular dental exams and cleanings so problems can be detected before they become painful—and expensive. Keeping your teeth and gums clean and healthy will help prevent most tooth decay and periodontal disease and is an important part of maintaining your medical health. You have a choice to buy up on (2) two new dental plans this year, each administered by Delta Dental. (See Section 1, Employee Rates for monthly premiums) You can see any dentist you choose, but benefits are highest when you use a provider in Delta Dentals PPO Network. Basic Services are paid at 90%, while Major Services are paid at 60%. DENTAL PREVENTIVE CARE IS FREE Regardless of the dental option you elect, you and each covered family member get one free dental exam/cleaning and x‐ray every six months. This benefit alone can offset a significant portion of the cost of coverage, and it helps keep your smile healthy. TO LOCATE A PARTICIPATING DENTAL PROVIDER: Visit www.deltadental.com or call 1‐800‐223‐3104, give them the Group Number #2603 to locate your specific provider.

Your Vision Plan Your vision coverage is provided through VisionBlue/EyeMed administered by Blue Cross Blue Shield. It provides coverage for routine eye exams and pays for all or a portion of the cost of glasses or contact lenses. You can see in‐ or out‐of‐network providers; however, you always save money if you see in‐network providers. In‐Network providers will also file claims for you. Anderson County Government has worked in conjunction with Blue Cross Blue Shield to provide you with the best possible Vision Care. The frame/contact lens allowance is now $150 with frames allowable every 24 months and contact lenses allowable every 12 month. Below is a Summary Plan Description of the VisionBlue Coverage. Keep in mind that all benefits are subject to the Covered Services and Limitation on Covered Services, Exclusions from Covered Services and Schedule of Benefits sections of the Evidence of Coverage.

VisionBlue Summary Plan Description

Vision Examination

Comprehensive Eye Exam $20 Copay Up to $35Retinal Imaging Up to $39 N/A

Contact Lenses Fit & Follow-up

Standard $55 Copayment Up to $0 Premium 10% off retail Up to $0 Vision Materials

Standard Plastic Lenses

Single Vision $20 Copayment Up to $30Bifocal $20 Copayment Up to $45

Trifocal $20 Copayment Up to $60

Frames

Frames $0 Copayment up to $150

allowance, 15% off balance over allowance

Up to $75

Contacts

Conventional $0 Copayment up to $150

allowance, 20% off balance over allowance

Out of Network Up to $120

Disposable $0 Copay up to $150 allowance Out of Network Up to $121Medically Necessary Paid in Full Up to $200

Lens Options

Standard Polycarbonate $40 Copayment Up to $0 Standard Polycarbonate (for covered dependent children under 19 years of age)

$0 copayment Up to $5

UV Treatment $15 Copayment Up to $0

Tint $15 Copayment Up to $0

Standard Plastic Scratch Coating $15 Copayment Up to $0 Standard Progressive Lenses (add on to Bifocal)

$65 Additional Copayment $0 Additional *

Premium Progressive Lenses (add on to Bifocal)

$65 Additional Copayment, 20% off retail price less $120 allowance

$0 Additional *

Standard Anti-Reflective Coating $5 Copayment Up to $0 Other Lens Options 20% off retail N/A

Diabetic Eye Care (Care and testing for diabetic members)Exam $0 Up to $77Retinal Imaging $0 Up to $50 Extended Ophthalmoscopy $0 Up to $15Gonioscopy $0 Up to $15Scanning Laser $0 Up to $33

**Some or all of the diagnostic services described above will be provided as deemed appropriate, subject to provider determination of service necessity and the benefit frequency limitations referenced above.

One exam within a 12 month period for each member covered under the plan.

One set of lenses within a 12 month period for each member covered under the plan.

One set of lenses within a 12 month period for each member covered under the plan. (In lieu of lenses + frames)

One pair of frames within a 24 month period for each member covered under the plan.

VisionBlue Coverage Group # 129714

In-Network Member Cost Out-of-Network Reimbursement

*$45 maximum reimbursement

One set of lenses within a 12 month period for each member covered under the plan.

Up to 2 services per year for each listed service.**

Employee Premium Monthly Rates All contributions are pre‐tax. Monthly Medical and Dental premiums are below. Deductions are taken on a bi-weekly pay schedule.

*Employees who completed the HRA (Biometric & Health Risk Assessment), within 30 days of effective insurance, will receive a monthly medical premium reduction of $25

Medical Coverage (Vision and Prescription Included)

Gold Plan Silver Plan

Employee Only $147.00 $106.00 Employee + One (Spouse or Child) $320.00 $278.00 Family $400.00 $364.00

Dental Coverage

Tier 3 Tier 2 Tier 1

Employee Only County Paid $3.58 $5.32

Family $26.42 $37.19 $42.40

Monthly Premiums

SECTION 2

Flexible Spending – Group & Supplemental Life – Additional Benefits

Flexible Spending

HEALTHCARE/DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT TASC will be administering our FSA program which helps you pay for health care and dependent care costs using tax‐free dollars. Each pay period, you decide how much money you would like to contribute to one or both accounts. Your contribution will be deducted from your paycheck on a pretax basis and put into the Health Care FSA, the Dependent Care FSA, or both. When you incur expenses, you can access the funds in your account to pay for eligible health care or dependent care expenses. TASC PREPAID MASTERCARD® CARD The TASC Card gives you fast and convenient access to your funds. When you incur an eligible expense, simply swipe the TASC Card. The card automatically pays for and substantiates most eligible expenses (up to the maximum amount available from your Flexible Spending Account) at the point of purchase, as long as the purchase is made at an approved vendor. Track account balance and activity, request a dependent card, and more from MyTASC (Manage My Card).

For a current list of allowable items/expenses, visit the IRS.gov website or view our Guide to Deductible Expenses. The TASC Card is issued by The Bancorp Bank pursuant to a license from Mastercard International Incorporated. The Bancorp Bank; Member FDIC. Mastercard is a registered trademark of Mastercard International Incorporated.

TASC MOBILE TECHNOLOGY (Mobile App and Text Messaging) TASC Mobile offers fast and easy account access from anywhere at any time! MyTASC Mobile App and MyTASC Text Messaging make it easy for FlexSystem Participants to access their accounts from their mobile device. Users appreciate these flexible wireless options to securely manage their accounts and request reimbursements while on the go.

Retrieve your account balance via a Text (SMS) Message. Text "TASC Bal" to 41411. Learn more by reading our TASC Text Messaging Instructions.

MY SPOUSE ALSO WORKS FOR THE COUNTY – CAN WE BOTH CONTRIBUTE TO THE FSA? Yes. You can both contribute to the Flexible Spending Account (FSA). You may each contribute up to the $2,700 annual limit. Note: FSA elections do not automatically continue from year to year; you must actively enroll each year.

Life and Accidental Death & Dismemberment (AD&D) BASIC LIFE & AD&D INSURANCE Life insurance is an important part of your financial security, especially if you support a family. Accidental Death & Dismemberment (AD&D) insurance is designed to provide a benefit in the event of accidental death or dismemberment.

Anderson County provides all benefit eligible employees Basic Life and AD&D Insurance equal to $50,000 at no cost to you. You have the option to 'buy up’ supplemental Life & AD&D insurance, as well as spouse/dependent supplemental coverage.

SUPPLEMENTAL LIFE & AD&D INSURANCE In addition to the company paid insurance, Anderson County provides you an opportunity to purchase Supplemental Life Insurance for yourself, spouse and children through payroll deductions. Additional coverage options are shown below.

Short Term Disability & Long Term Disability Insurance Coverage SHORT-TERM DISABILITY INSURANCE COVERAGE Short Term Disability insurance provides income replacement should you become disabled and unable to work due to a non-work-related illness or injury. Anderson County provides eligible employees with short‐term disability coverage through USAble/BCBS, at no cost to the employee. Short Term Disability will pay 60% of your base pay with a 15 day elimination period, for up to 13 weeks. American Fidelity offers a supplemental Short Term Disability policy which will allow you to purchase up to 40% of your base pay. If chosen, the two combined will allow you to continue to draw 100% of your base pay. LONG-TERM DISABILITY INSURANCE COVERAGE Anderson County does not provide long‐term disability coverage; however, it is available for full time employees to purchase through American Fidelity. Long‐term disability coverage, continues a portion of your paycheck if injury or illness keeps you out of work longer than your Short Term Disability coverage allows. There is a pre‐existing limitation for STD and LTD disability coverage. If you become disabled during your first year of coverage as a result of a condition you had in the 12 months prior to your disability effective date no benefits are available for that disability.

Additional Benefits You can’t always plan for accidents or a serious illness, but you can be better prepared financially when they do happen with additional products through American Fidelity. Quality health and disability insurance plans aren’t always enough. There may still be coverage gaps. For example, your medical coverage may have deductibles and copays and may not fully cover out‐of‐network treatments. And if you’re out on disability, only a portion of your income may be covered. Most people will need the means to cover these extra medical and daily living expenses, such as groceries, housing expenses, car payments, and more. You pay the cost through convenient payroll deduction.

AMERICAN FIDELITY VOLUNTARY PRODUCTS:

• SHORT AND LONG TERM DISABILITY pays a cash benefit if you can't work due to a covered injury or illness that is not work related.

• CANCER plans can help ease the impact on your finances. Benefits payments are made directly to you and allow you to pay for expenses such as, copays, mortgage, and car payments etc.

• ACCIDENT policies provide 24‐hour coverage for accidents that occur both on and off the job and can help offset medical expenses.

• CRITICAL ILLNESS insurance can help financially if you experience an event such as a heart attack or stroke. This is paid out in a lump sum amount.

• TERM LIFE insurance provides short‐term coverage at a competitive price, while Whole Life Insurance provides lifelong protection.

• PERMANENT LIFE (TEXAS LIFE) is a portable, permanent, life insurance policy that is effective until 121 years old. It can cover you,

• spouse, children and grandchildren • *NEW – HOSPITAL ASSIST

SECTION 3

Retirement – Glossary of Terms – Contact List

TCRS – RetireReadyTN.gov RETIREMENT PLAN INFORMATION FOR EMPLOYEES OF LOCAL GOVERNMENT ENTITIES ELECTING TO PARTICIPATE RetireReadyTN is the state’s retirement program, combining the strengths of a defined benefit plan provided by the Tennessee Consolidated Retirement System (TCRS), 401(k) and 457 plans through services provided by Empower Retirement, and retirement readiness education. We strive to empower public employees to take actionable steps toward preparing for the future.

ABOUT TENNESSEE CONSOLIDATED RETIREMENT SYSTEM (TCRS) TCRS is a defined benefit plan providing lifetime retirement, survivor and disability benefits for members and their beneficiaries. After meeting vesting requirements, a member becomes eligible to receive a monthly retirement benefit upon reaching the age and/or service requirement. Benefits are calculated based on the member’s years of creditable service, average final compensation (AFC), age, and the benefit accrual factor. AFC is the average of the highest five consecutive years of compensation. Member Annual Statements are available by logging into Self‐Service at MyTCRS.com.

ABOUT THE 401(K) AND 457 PLANS The amount available in retirement is based on contributions, plus accumulated earnings (if any)

to the member’s account. Upon terminating employment or retiring, an employee may leave the account balance in the plan, roll it over to another qualified plan, or begin taking distributions. Members select their investment options based on their individual goals, risk tolerance, and timeline. Members may access and make changes to their 401(k) or 457 account by logging in to RetireReadyTN.gov or calling 800‐922‐7772. If the member withdraws money from the 401(k) account balance prior to age 59 ½, they may be subject to an early distribution tax.

RETIREMENT READINESS EDUCATION

In addition to retirement plans, RetireReadyTN offers retirement readiness education and retirement counseling to all members. Members can meet with a local RetireReadyTN plan advisor for assistance with retirement planning or to discuss other financial planning needs. These services are provided to members at no additional fee. To find your local representative and schedule a one‐on‐one or group meeting, please visit RetireReadyTN.gov.

DESIGNATE A BENEFICARY One of the most important decisions a member can make is to designate a beneficiary(s). Designations for TCRS benefits and the 401(k)/457 accounts are made separately. In the event of a member’s death, survivor benefits may be available to designated beneficiaries. Situations such as marriage, divorce, remarriage, or death do not automatically change a designated beneficiary(s). *For more information, refer to our ‘Selecting a Beneficiary’ guide on RetireReadyTN.gov.

Glossary Brand Name Drugs — Drugs that have trade names and are protected by patents. Brand name drugs are generally the most costly choice.

Coinsurance — The percentage of a covered charge paid by the plan. You are responsible for your portion of the Co‐Insurance on each claim. It will be either 20% or 30%.

Copayment (Copay) — A flat dollar amount you pay for medical or prescription drug services regardless of the actual amount charged by your doctor or health care provider.

Deductible — The annual amount you and your family must pay each year before the plan pays benefits. Eligible Employees — Employees must be full‐time, permanent staff members of Anderson County Government to be considered eligible for benefits. Employer paid/contributed retirement and short term disability require a 6 month waiting period. Employer paid/contributed other benefits require a 30day, first of next month employment to be eligible for benefits.

Flexible Spending Account — A Flexible Spending Account (FSA) is a pre‐tax benefit account that's used to pay for eligible medical, dental, and vision care expenses that are not covered by your health care plan or elsewhere. With an FSA, you use pre‐tax dollars to pay for qualified out‐of‐ pocket health care expenses. These dollars are loaded onto a debit card in full the date they are effective. The amount selected is then paid back via payroll deduct over the course of the remaining fiscal year. Fully-Insured Program — A health insurance plan in which an employer pays a specific premium amount to an insurance company to get coverage for a specific number of employees.

Generic Drugs — Generic drugs are less expensive versions of brand name drugs that have the same intended use, dosage, effects, risks, safety and strength. The strength and purity of generic medications are strictly regulated by the Federal Food and Drug Administration.

In-Network — Use of a health care provider that participates in the plan’s network. When you use providers in the network, you lower your out‐of‐pocket expenses because the plan pays a higher percentage of covered expenses.

Out-of-Network — Use of a health care provider that does not participate in a plan’s network. Mail Order Pharmacy — Mail order pharmacies generally provide a 90‐day supply of a prescription medication for the same cost as a 60‐day supply at a retail pharmacy. Plus, mail order pharmacies offer the convenience of shipping directly to your door.

Inpatient — Services provided to an individual during an overnight hospital stay.

Outpatient — Services provided to an individual at a hospital facility without an overnight hospital stay.

Out-of-Pocket Maximum —The maximum amount you and your family must pay for eligible expenses each plan year. Once your expenses reach the out‐of‐pocket maximum, the plan pays benefits at 100% of eligible expenses for the remainder of the year, except for prescriptions under all medical plans except the HSA Plan.

Primary Care Physician (PCP) — Physician (generally a family practitioner, internist or pediatrician) who provides ongoing medical care. A primary care physician treats a wide variety of health‐related conditions. Self-Funded — Health care also known as Administrative Services Only (ASO), is a self-insurance arrangement whereby an employer provides health or disability benefits to employees with its own funds.

Specialist — A physician who has specialized training in a particular branch of medicine (e.g., a surgeon, gastroenterologist or neurologist).

Important Information about Your Health Plan MedBen is pleased to have been chosen by Anderson County Government as your benefits administrator. We are committed to providing you with a quality health care experience.

Medical Benefits Administrators, Inc. was established in 1989 and is a subsidiary of Medical Benefits Mutual Life Insurance Company, which has provided insurance and benefits services since 1938. The companies are collectively known as MedBen and provide quality benefits services for employees and dependents nationwide.

Below is information that will be valuable as you utilize your benefits. Much of this information will be printed on your identification card and in your plan booklet. We hope this sheet serves as an easy reference guide.

Contact MedBen Website medben.com Email Address medben@medben.com Customer Service (800) 423‐3151

Contact Your Provider Network PHCS serves as your medical network. Customer Service (800) 922‐4362 Website (provider searches) www.multiplan.com Claims Address: MedBen, P.O. Box 1099 Newark, OH 43058‐1099

Contact Your Pharmacy Services Administrator Ventegra serves as your pharmacy services administrator. Website ventegra.net Customer Service (877) 867‐0943

Contact Your Mail Order Pharmacy MedVantx and Costco serve as your mail order pharmacies. MedVantx Costco Phone (866) 744‐0621 Phone (800) 607‐6861 Website medvantxrx.com Website pharmacy.costco.com Address Address P.O. Box 5736 215 Deininger Circle Sioux Falls, SD 57117 Corona, CA 92880‐9911

Contact Your Utilization Review (UR) Administrator Hines & Associates provides UR services for Anderson County. Call 888‐461‐0018 48 hours prior to an elective hospitalization or surgery.

Frequently Asked Questions

Q: What do I do if my physician is not a participating provider? A : You may request that physicians and other licensed providers be

contracted to participate in the plan. Please contact your provider network for additional information.

Q: Do I need to fill out a claim form if I go to a

participating provider? A : No, part of the agreement for participating providers requires them to prepare and submit a

claim form for reimbursement. They should collect your office visit copay where necessary, and bill MedBen Administrators for the balance.

Q: Do I need to fill out a claim form if I go to a provider that is not participating in the

network? A : You may be required to complete and submit a claim form if the provider is not participating in

the network. Q: How do I order additional identification cards? A : You may order supplies or respond to many requests for information by calling our toll‐free 800

number or by sending an email request or response to medben@medben.com (use your SS# as identification).

About MedBen Correspondence

There are times when we will need updated information to process your claims. We are happy to take this information over the phone or via email (medben@medben.com) – but here’s what we will need to verify annually:

Infrequent Requests for Information

Other Insurance Information – When you enroll, you should inform us if one of your dependent children has other insurance through a different parent or step‐parent that is primary to this plan. However, if we do not have this information when a claim comes in, we will request documentation of other coverage so that we may update our records. This will be requested in the form of a questionnaire completed by you. We generally request this information annually.

Sometimes a person is court‐ordered to provide coverage for a dependent who would otherwise not be eligible for coverage. In those instances, we will need to be advised of the arrangement and have a copy of the decree on file so that our records may be updated.

On an annual basis, we will also ask if your spouse has obtained any other insurance coverage that could be primary to your plan.

You may respond to our questions via phone or by e‐mail. However, we do need responses before we can pay your claims, so please do not hesitate to call or email anytime you have questions or receive correspondence from MedBen.